63943_Robert Macmillan_20190312

9CAMA / ❑ DREDGE & FILL
GENERAL '. -PERMIT
❑New' .-❑Modifi'cation ,ZConiplete,Reissue ❑Partial Reissue
As authoriied-by.the State of North Carolina, Department of Environmental -Quality
and -the Coastal Resources Commis "ion in an area of environmental concern pursuant to 15A NCA
., . -
Applicant Name ��54 !" -A& Ae wl '/G%� Project Locatio
Address Street Address/
City d G� r-A(ATiG Stat ZIP
No. .7297'6 . '
C, 'D .
Previous permit #' ?o? i
Date previous.permit issued
Rules attached.
n: County G C�
State Roa/d/' Lot
' . i(..�
'Phone #(,� �7)�PI� U E-Mail
Subdivision
Authorized Agent
�Z�tilr d'. Giil� �G�?S"
City �G�irr ��/�
ZIP
Affected CW
ElOEA
[ VEW )6-PTA DES ElPTS
ElHHF ❑ IH ElUBA ❑ N/A
Phone # ( ) Riv�eer' Basin /
AEC(s):
Adj. Wtr. Body����
r ` nat man unkn
❑ PWS:
ORW: yes / no
PNA yes / no
Closest Maj. Wtr. Body
Type of Project/ Activity
7- /�Z
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A building permit may be required by: ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
:Notes/Sp ciai-Con rtions
-Agent or Applica Printed Name
Signature Pteae rea ompJiance state,gent on back of permit
Permi •Of i ef's�Printeed Name /
Sign ture /
Issuing Date Expiration Date-

f
-2
CAI -DREUGEt
7 441
07,-­
#Ao", - VA
RA revious permit
7,
ue
b U&kofii�jefital,QUality­
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and flie.Goastalc;s G
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Project
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.-Addr
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OCW EW-, ;--�ULPTA -�OES -OPTS Phone-# - River Basin
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-AEt(s):-, -71 ------ -
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Clbsest-M4.-Wt�.-B'd
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'note o
A'66111dlng`permli may."bq,rq u See n bac�, Basin
re
garding required -by: Y': )r - - _' ' ./14
d b 7 FB rules.
hloteg/ Special Conditions "_.-1-.
'.Agent—, or_A00li6nt 1I d N P&- e
5111 Fl asp r md' compliance statement on back of
-'llication Fee(s)
Date
j
Da
te-'

NC Division of Coastal Mgt. -
Applicant:
Date: /A �)x,,-, '
General Permit #:���
Habitat Impact com puter Sheet
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
-, FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other ❑ .
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑-
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ - Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑